• 제목/요약/키워드: Benefit ratio

검색결과 600건 처리시간 0.031초

131I-Labeled-Metuximab Plus Transarterial Chemoembolization in Combination Therapy for Unresectable Hepatocellular Carcinoma: Results from a Multicenter Phase IV Clinical Study

  • Ma, Jun;Wang, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7441-7447
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    • 2015
  • Objective: This study evaluated the safety and objective response of combining $^{131}I$-labeled-metuximab (Licartin) with transarterial chemoembolization (TACE) in the treatment of unresectable hepatocellular carcinoma (HCC). Materials and Methods: In a multicenter open-label clinical trial, 341 enrolled patients with stage III/IV HCC according to TNM criteria were nonrandomly assigned to a trial group (n=167) and a control group (n=174), undergoing TACE following hepatic intra-arterial injection of licartin or TACE alone from July 2007 to July 2009. Radiopharmaceutical distribution was evaluated. The primary endpoint was overall survival; secondary endpoints included time-to-progression (TTP), toxicity and adverse events (AEs). Results: The radiobiological distribution demonstrated better localization of licartin in liver tumors than other tissues (P<0.01). The organ absorbed doses to liver and red marrow were $3.19{\pm}1.01Gy$ and $0.55{\pm}0.22Gy$, respectively. The 1-year survival rate was significantly higher [79.47% vs. 65.59%, hazard ratio (HR), 0.598, P=0.041] and TTP significantly improved ($6.82{\pm}1.28$ vs. $4.7{\pm}1.14months$, P=0.037) compared with the control group. Patients at stage III achieved more benefit of one year survival than stage IV in the trial group (86.9% vs. 53.8%, P<0.001). There were significant different toxicities in leukocytopenia, thrombocytopenia and increased total bilirubin level [P<0.001, P=0.013, P<0.01, relative risk (RR) 1.63, 1.33, 1.43], but no differences in severe AEs of upper GI hemorrhage and severe liver dysfunction between the groups (5.39% vs. 2.3%, P=0.136). Conclusions: Owing to excellent tumor-targeting, promised efficacy and favourable toxicity profile, the novel combination therapy of licartin and TACE could be applied in patients with unresectable HCC.

High and Low Dose Folinic Acid, 5-Fluorouracil Bolus and Continuous Infusion for Poor-Prognosis Patients with Advanced Colorectal Carcinoma

  • Bano, Nusrat;Najam, Rahila;Mateen, Ahmed;Qazi, Faaiza
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3589-3593
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    • 2012
  • Objective: Evaluation and assessment of response rate, duration and toxicity in patients subjected to 5-FU based chemotherapy. Background: The therapeutic ratio shifts with different 5FU/LV regimens and none yet serve as the internationally accepted Gold Standard. A bimonthly regimen of high dose leucovorin is reported to be less toxic and more effective than monthly low dose regimens. We here compare therapeutic responses and survival benefit of the two regimens in poor prognosis patients with advanced colorectal carcinoma. Patients and Methods: A total of 35 patients with histologically confirmed colorectal carcinoma were subjected to de Gramont and Mayo Clinic regimen. Nineteen patients were treated with high dose folinic acid ($200mg/m^2$), glucose 5%, 5-FU ($400mg/m^2$) and 22 hr. CIV ($600mg/m^2$) for two consecutive days every two weeks. These patients had failed responses to previous chemotherapy and were above sixty years of age with poor general status. Sixteen patients (six below 60 years) with progressive disease were subjected to low dose folinic acid ($20mg/m^2$)for five days, 5FU($425mg/m^2$) injection bolus for 5 days, every five weeks. An initial evaluation was made in sixty days and responders were reevaluated at sixty days interval or earlier in case of clinical impairment. Based on positive prognosis, the therapy was continued. Evaluation of treatment response was made on the basis of WHO criteria. Results: The response rate was 44% in thirty four evaluable patients, with 4 complete responses (11.8%) and 11 (32.4%) partial responses. The two schedules were well tolerated, whereas, mild toxicity without WHO Grade ${\geq}2$ events was assessed. The response duration was extended (12 months) in a few patients with age above sixty years treated by high dose bimonthly regimen of 5FU/LV. Conclusion: The regimens are safe and effective in advanced colorectal carcinoma patients with poor general status.

한글판 Louisville Instrument for Transplantation 설문지의 신뢰도 및 타당도 평가 (Evaluation of Reliability and Validity of the Louisville Instrument for Transplantation (LIFT) in Korean Population)

  • 김홍민;김지훈;황재하;김광석;이삼용
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.245-250
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    • 2011
  • Purpose: Composite tissue allotransplantation has emerged as a new therapeutic modality to reconstruct major tissue defects of the head, neck and extremities. A questionnaire-based instrument, the Louisville Instrument for Transplantation (LIFT), has been developed to objectively assess the risk-versus-benefit ratio for composite tissue allotransplantation procedures. The objective of this study is to assess if the LIFT is a useful, reliable and valid tool to apply to the Korean population. Methods: Seventy-three medical students and 60 lay public completed the LIFT questionnaire (translated to Korean) over the period from February 2010 to April 2010. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was analyzed using Pearson's correlation coefficient. Construct validity was assessed by comparing Pearson's correlation coefficients between perceived improvements in quality of life and responses to risk tolerance questions concerning organ transplants. Results: Measurements of the test-retest reliability showed that Pearson's correlation coefficients ranged from 0.241 to 0.902, and Cronbach's alphas ranged from 0.52 to 0.80 for medical students and from 0.63 to 0.83 for the lay public. Pearson's correlation coefficients showed significant correlations between perceived improvements in quality of life and responses to risk tolerance questions concerning organ transplants. Hand transplant showed a significant correlation in medical students. Foot, hand, two hands, larynx, partial face transplants showed significant correlations for the lay public. Conclusion: The applicability of the LIFT to the Korean population was found to be reliable and valid. The LIFT may serve as a useful tool for clinical application in the Korean population.

Is neoadjuvant androgen deprivation therapy beneficial in prostate cancer treated with definitive radiotherapy?

  • Eom, Keun-Yong;Ha, Sung W.;Lee, Eunsik;Kwak, Cheol;Lee, Sang Eun
    • Radiation Oncology Journal
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    • 제32권4호
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    • pp.247-255
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    • 2014
  • Purpose: To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. Materials and Methods: We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. Results: Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose ${\geq}70Gy$ (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose ${\geq}70Gy$ was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). Conclusion: NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.

Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • 제34권3호
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

Effect of Crop Establishment and Weed Control Method on Productivity of Transplanted aman Rice

  • Ali, Mohammad;Haque Bir, Md. Shahidul;Rahman, Md. Habibur;Ayesha, Sultana Kaniz;Hoque, Aminul;Harun-Ar-Rashid, Md.;Islam, Md. Rashidul;Park, Kee Woong
    • Weed & Turfgrass Science
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    • 제7권2호
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    • pp.120-129
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    • 2018
  • This experiment was conducted to find the most suitable crop establishment method and weed management practices for transplanted aman rice in Bangladesh. Rice variety Bangladesh Rice Research Institute (BRRI) dhan44 was used as planting materials where three crop establishment methods ($T_1$: direct wet seeding by drum seeder; $T_2$: hand broadcasting; $T_3$: transplanting) and four weeding options ($W_1$: Hand weeding (HW); $W_2$: BRRI weeder+HW; $W_3$: Herbicide+HW; and $W_4$: no weeding) were tested. Among the crop establishment methods, the highest grain yield ($5.12t\;ha^{-1}$) was obtained with the $T_3$, while the highest benefit cost ratio (BCR) of 2.08 was found in $T_2$. In case of the weed management method, $W_1$ showed superior results on the plant $density/m^2$ (139.66) at 60 days after transplanting (DAT), grain yield ($4.97t\;ha^{-1}$), and BCR (2.03). On the other hand, the highest plant dry matter (36.20 g) at 60 DAT and the highest yield ($6.10t\;ha^{-1}$) were obtained in a $T_3W_1$ combination. The results of this study show that the productivity of rice during aman season could be most significantly increased with the use of transplanting ($T_3$) alone, hand weeding ($W_1$) alone, or a combination of the two methods ($T_3W_1$).

Effects of Feeding Corn-lablab Bean Mixture Silages on Nutrient Apparent Digestibility and Performance of Dairy Cows

  • Qu, Yongli;Jiang, Wei;Yin, Guoan;Wei, Chunbo;Bao, Jun
    • Asian-Australasian Journal of Animal Sciences
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    • 제26권4호
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    • pp.509-516
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    • 2013
  • This study estimated the fermentation characteristics and nutrient value of corn-lablab bean mixture silages relative to corn silages. The effects of feeding corn-lablab bean mixture silages on nutrient apparent digestibility and milk production of dairy cows in northern China were also investigated. Three ruminally cannulated Holstein cows were used to determine the ruminal digestion kinetics and ruminal nutrient degradability of corn silage and corn-lablab bean mixture silages. Sixty lactating Holstein cows were randomly divided into two groups of 30 cows each. Two diets were formulated with a 59:41 forage: concentrate ratio. Corn silage and corn-lablab bean mixture silages constituted 39.3% of the forage in each diet, with Chinese wildrye hay constituting the remaining 60.7%. Corn-lablab bean mixture silages had higher lactic acid, acetic acid, dry matter (DM), crude protein (CP), ash, Ca, ether extract concentrations and ruminal nutrient degradability than monoculture corn silage (p<0.05). Neutral detergent fiber (NDF) and acid detergent fiber (ADF) concentrations of corn-lablab bean mixture silages were lower than those of corn silage (p<0.05). The digestibility of DM, CP, NDF, and ADF for cows fed corn-lablab bean mixture silages was higher than for those fed corn silage (p<0.05). Feeding corn-lablab bean mixture silages increased milk yield and milk protein of dairy cows when compared with feeding corn silage (p<0.05). The economic benefit for cow fed corn-lablab bean mixture silages was 8.43 yuan/day/cow higher than that for that fed corn silage. In conclusion, corn-lablab bean mixture improved the fermentation characteristics and nutrient value of silage compared with monoculture corn. In this study, feeding corn-lablab bean mixture silages increased milk yield, milk protein and nutrient apparent digestibility of dairy cows compared with corn silage in northern China.

Helicobacter Pylori Associated Gastritis Increases Risk of Colorectal Polyps: a Hospital Based-Cross-Sectional Study in Nakhon Ratchasima Province, Northeastern Thailand

  • Tongtawee, Taweesak;Kaewpitoon, Soraya;Kaewpitoon, Natthawut;Dechsukhum, Chavaboon;Leeanansaksiri, Wilairat;Loyd, Ryan A;Matrakool, Likit;Panpimanmas, Sukij
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.341-345
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    • 2016
  • Background: Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population. Materials and Methods: A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations. Results: The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 - 3.86), p < 0.01]. Patients with Helicobacter pylori - associated gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 - 7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status. Conclusions: This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.

Economic Evaluation of Prostate Cancer Screening Test as a National Cancer Screening Program in South Korea

  • Shin, Sangjin;Kim, Youn Hee;Hwang, Jin Sub;Lee, Yoon Jae;Lee, Sang Moo;Ahn, Jeonghoon
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3383-3389
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    • 2014
  • Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

Androgen Receptor Expression and its Correlation with Other Risk Factors in Triple Negative Breast Cancers: a Report from Western Iran

  • Payandeh, Mehrdad;Shazad, Babak;Madani, Seyed-Hamid;Ramezani, Mazaher;Sadeghi, Masoud
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3321-3324
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    • 2016
  • Background: Androgen receptors (ARs) are expressed in more than 70% of breast cancers (BCs) and have been implicated in BC pathogenesis. Some triple negative (TN)BC tumors express AR and may benefit from AR-targeted therapies. The aim of this study was to evaluate survival and the prevalence of AR expression and its correlation with other risk factors in triple negative BCs in women from Western Iran. Materials and Methods: In a retrospective study between 2009-2015, 41 patients with TNBC were referred to the Private Clinic of Oncology, Kermanshah city, Iran. ER, PR and AR-positive expression was defined as ${\geq}10%$ nuclear staining and also HER2 (2+), FISH was performed. Nuclear staining was considered representative for Ki67 and P53. The mean follow-up for the patients was 25 months. In this time, 5 patients died and 4 lost to follow-up were censored from survival analysis. Results: The mean age at diagnosis was 46.9 years (range, 24-71 years) and all patients were female. The OS rates for AR-positive and AR-negative patients were 90% and 85.1%, respectively, and the mean OS was 26.3 and 23.2 months. Therefore, there was no significant difference between the two groups (Hazard ratio: 0.580, 95% CI: 0.086-3.893, P=0.575). Conclusions: In TNBC patients, evaluation of AR status may provide additional information on prognosis and treatment. The results of studies showed that the prevalence AR expression may differ in the world and probably ethnicity can be an influencing factor.